典藏书目

If excessive sweating leads to the patient crossing their hands over the heart area, experiencing palpitations (Xin Ji, palpitations of the heart) that are relieved by pressure, Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction) should be used (see entry on Palpitations).

The distinction between Jing (Jing, sudden fright/shock) and Ji (Ji, palpitations/heart flutters) is clearly analyzed in miscellaneous diseases. In Shanghan (Cold Damage), there are cases mentioning only "Jing" and cases mentioning only "Ji"; since the principles differ, they are separated into two discussions. The only case where both "Jing" and "Ji" are mentioned together is in Shaoyang disease characterized by deafness, red eyes, chest fullness, and irritability; vomiting and purging methods must not be used. If mistakenly applied, vomiting or purging will result in Ji and Jing.

Haizang Fuling Wan (Sea Store Poria Pill): Treats post-Shanghan conditions or those caused by mental labor and fatigue, presenting with emaciated limbs, empty-hearted palpitations (Xin Song), and shortness of breath.
Ingredients: Fushen (Poria with Hostwood), Maidong (Ophiopogon Tuber, heart removed), Shudi (Prepared Rehmannia Root) (each 1 liang); Mudanpi (Tree Peony Bark), Renshen (Ginseng Root), Huangqi (Astragalus Root); Guizhi (Cinnamon Twig), Zhigancao (Honey-fried Licorice Root); Niuxi (Achyranthes Root), Zexie (Alisma Rhizome) (each 0.5 liang). Grind all ingredients into a fine powder, mix with refined honey, and pound/beaten 300-500 times. Form pills the size of paulownia seeds. Take 20 pills before meals, washed down with warm wine.

Xijiao Tang (Rhinoceros Horn Decoction): Treats lingering heat lurking in the Heart after Shanghan, presenting as Zhengchong (palpitations with anxiety), Jingji (startle palpitations), and insomnia.
Ingredients: Xijiao xie (Rhino Horn Shavings, half liang, shaved); Yinchenshao (Artemisia Capillaris Herb, 7.5 qian); Fuling (Poria, 2 liang); Shaoyao (Peony Root, 2 liang); Shengdihuang (Fresh Rehmannia Root, baked, 2 liang); Maidong (Ophiopogon Tuber, heart removed, 1.5 liang); Shanzhi (Gardenia Fruit, half liang). Coarsely crush the ingredients. Take 5 qian per dose, add 1 zhang of water, 2 slices of Shengjiang (Fresh Ginger), and 30 Zhu Ye (Bamboo Leaves). Decoct until 70% remains. Take after meals.

Maidong Fuling Yinzi (Ophiopogon and Poria Infusion): Treats post-Shanghan conditions with vague spirit (Shen Hunhuang) and inability to lie down.
Ingredients: Maidong (Ophiopogon Tuber, heart removed); Chifuling (Red Poria, peel removed); Zhimu (Anemarrhena Rhizome, baked); Xiong (Ligusticum Rhizome); Zhigancao (Honey-fried Licorice Root); Suanzaoren (Ziziphus Seed, lightly stir-fried); Chenpi (Tangerine Peel, white pith removed and stir-fried); Binglang (Areca Seed) (each 1 liang). Coarsely crush the ingredients. Take 5 qian per dose, add 1.5 zhang of water and 5 slices of Shengjiang (Fresh Ginger). Decoct, take warm. Three times daily.

The term "Jing Huai Bing" (Fright-induced complicated disease) refers to conditions caused by mistaken purging, fire therapy counter-indications, or warm needle treatment. Zhang Zhongjing’s method is simply to regulate according to the deviation of the pathogen.

In Shanghan, if after eight or nine days, purging is performed leading to chest fullness, irritability, startle/palpitations, difficulty urinating, delirium, and whole-body heaviness making turning difficult, Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) is the primary treatment. (Cheng Wuji commentary: When Shanghan reaches eight or nine days, the pathogenic factor has transformed into heat and transmitted to the Yang meridians. Purging at this time damages the interior while heat persists. Chest fullness and irritability indicate Yang-heat lodging in the chest. Startle occurs because the Heart dislikes heat and the Spirit does not remain anchored. Difficulty urinating indicates interior deficiency and impaired fluid circulation. Delirium indicates Stomach heat. Whole-body heaviness and immobility indicate Yang Qi moving inward and failing to nourish the exterior. This formula uses Chaihu Tang to resolve chest fullness and irritability; adds Longgu (Dragon Bone), Muli (Oyster Shell), and Qiandan (Lead Monoxide) to anchor the Spirit and calm startle; adds Fuling (Poria) to promote fluid circulation and diuresis; adds Dahuang (Rhubarb Root) to purge Stomach heat and stop delirium; adds Guizhi (Cinnamon Twig) to circulate Yang Qi and resolve body heaviness and mixed pathogens. Thus, all symptoms are resolved.)

Chaihu Jia Longgu Muli Tang Formula:
Banxia (Pinellia Tuber, washed in hot water, 2 he); Chaihu (Bupleurum Root, 4 liang); Dahuang (Rhubarb Root, 2 liang); Renshen (Ginseng Root); Guizhi (Cinnamon Twig, coarse bark removed); Fuling (Poria); Longgu (Dragon Bone); Qiandan (Lead Monoxide); Muli (Oyster Shell, calcined); Shengjiang (Fresh Ginger) (each 1.5 liang); Dazao (Jujube Fruit, 6 pieces). Eleven ingredients. Add 8 sheng of water, decoct to obtain 4 sheng. Add chopped Dahuang, boil for one or two more boils. Strain. Take 1 sheng warm.

If Shanghan presents with a floating pulse, and the physician uses fire methods to force sweating, causing Yang collapse, it inevitably leads to Jingkuang (frightened madness), restlessness, and inability to lie still. Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang (Cinnamon Twig Decoction without Peony plus Kochia Herb, Dragon Bone, and Oyster Shell to Rescue Deviation) is the primary treatment. (Cheng Wuji commentary: A floating pulse in Shanghan indicates the pathogen is in the exterior. Using fire methods to劫 (rob/coerce) sweat causes excessive sweating, leading to Yang collapse. Sweat is the fluid of the Heart; Yang collapse implies Heart Qi deficiency. The Heart dislikes heat; internal forcing by fire pathogen causes the Spirit to float outward, resulting in frightened madness, restlessness, and inability to lie still. Use Guizhi Tang to resolve residual exterior pathogens. Remove Shaoyao (Peony Root) because Shaoyao benefits Yin, which is unsuitable for Yang collapse. For chaotic fire pathogen, add Shuqi (Kochia Herb) for its acridity to disperse. For collapsing Yang, add Longgu (Dragon Bone) and Muli (Oyster Shell) for their astringency to secure leakage. Materia Medica states: "Astringents can treat collapse." Longgu and Muli belong to this category.)

Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang Formula:
Guizhi (Cinnamon Twig, coarse bark removed); Shengjiang (Fresh Ginger, sliced); Shuqi (Kochia Herb, washed to remove fishy smell) (each 3 liang); Muli (Oyster Shell, calcined, 5 liang); Longgu (Dragon Bone, 4 liang); Zhigancao (Honey-fried Licorice Root, 2 liang); Dazao (Jujube Fruit, 12 pieces, split). Grind into powder. Add 12 sheng of water, first decoct Shuqi until reduced by 2 sheng, then add other herbs. Decoct to obtain 3 sheng. Strain. Take 1 sheng warm.

Taiyang Shanghan (Sun-Yang Cold Damage) treated with warm needles will inevitably cause Jing (startle/fright). (The Heart belongs to Fire; Fire enters the Heart first. The Heart governs Blood and houses the Spirit. Blood is like water; Spirit is like a fish. When two Yangs [pathogenic heat and needle heat] scorch each other, it is like boiling water; the fish [Spirit] becomes startled and jumps, unable to remain tranquil.) Fengwen (Wind-Warmth) presents with a floating pulse, spontaneous sweating, body heaviness, and somnolence. If treated with fire therapy, mild cases result in jaundice; severe cases resemble convulsive epilepsy with spasms. (This discussion appears in the Wind-Warmth chapter.)

Wu Kun stated: Generally, after Shanghan has been treated with sweating, vomiting, or purging, patients who are extremely deficient, or whose minds are unsettled due to unresolved matters, often develop Jingji (startle palpitations). They should be treated with formulas that nourish Blood, calm the Spirit, and anchor the Heart, such as Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill).